BACKGROUND In December 2019, COVID-19 outbreak occurred in Wuhan. Data on the clinical characteristics and outcomes of patients with severe COVID-19 are limited. OBJECTIVE The severity on admission, complications, treatment, and outcomes of COVID-19 patients were evaluated. METHODS Patients with COVID-19 admitted to Tongji Hospital from January 26, 2020 to February 5, 2020 were retrospectively enrolled and followed-up until March 3, 2020. Potential risk factors for severe COVID-19 were analyzed by a multivariable binary logistic model. Cox proportional hazard regression model was used for survival analysis in severe patients. RESULTS We identified 269 (49.1%) of 548 patients as severe cases on admission. Elder age, underlying hypertension, high cytokine levels (IL-2R, IL-6, IL-10, and TNF-a), and high LDH level were significantly associated with severe COVID-19 on admission. The prevalence of asthma in COVID-19 patients was 0.9%, markedly lower than that in the adult population of Wuhan. The estimated mortality was 1.1% in nonsevere patients and 32.5% in severe cases during the average 32 days of follow-up period. Survival analysis revealed that male, elder age, leukocytosis, high LDH level, cardiac injury, hyperglycemia, and high-dose corticosteroid use were associated with death in patients with severe COVID-19. CONCLUSIONS Patients with elder age, hypertension, and high LDH level need careful observation and early intervention to prevent the potential development of severe COVID-19. Severe male patients with heart injury, hyperglycemia, and high-dose corticosteroid use may have high risk of death. OBJECTIVES To investigate the effect of kidney function on stone composition and urinary mineral excretion in patients undergoing surgical intervention for nephrolithiasis. METHODS Using our institutional kidney stone database, we performed a retrospective review of stone patients who underwent surgical intervention between 2004 and 2015. https://www.selleckchem.com/products/nf-kb-activator-1.html Patients' demographic information, 24-hour urinary mineral excretion, and stone characteristics were reported. The patients' estimated glomerular filtration rates (eGFR) were compared with their stone compositions and 24-hour urine mineral excretions. RESULTS A statistically significant difference was noted between the groups, with uric acid stones being associated with lower eGFR and calcium phosphate stones associated with higher eGFR. No relationship could be demonstrated between eGFR and calcium oxalate or struvite stones. Patients with lower eGFR also demonstrated a statistically significant association with lower urinary pH as well as lower urinary excretion of calcium and citrate. CONCLUSIONS While various factors have been found to play significant roles in kidney stone formation and composition, our findings demonstrate a definite relationship between these and renal function. This paper highlights the fact that renal function evaluation should be considered an important component in the evaluation, counseling, and management of patients with nephrolithiasis. OBJECTIVES To evaluate the relationship between dynamic changes in the modified Glasgow Prognostic Scale (mGPS) and post-nephrectomy survival among localized clear cell renal cell carcinoma (ccRCC) patients. METHODS We retrospectively identified patients who underwent nephrectomy for localized ccRCC with preoperative mGPS?=?0 from 2005 to 2018. The primary exposure of interest was ΔmGPS between two points 60 days prior to surgery and 1 year after surgery. We assessed the relationship between ΔmGPS and survival outcomes. Kaplan-Meier curves were generated to determine survival estimates and Cox proportional hazards models were fit to estimate hazard ratios. Multivariable models were constructed using both ΔmGPS and clinical variables known to be associated with differences in survival. RESULTS We identified 313 patients for our analytic cohort with a median follow-up time of 20.2 months. 37 (11.9%) patients died and 39 (12.54%) showed recurrence during follow-up. 263 (84.6%) patients had unchanged mGPS before and after surgery, while 48 (15.4%) patients showed an increase in postoperative mGPS from preoperative mGPS. Compared to patients with unchanged mGPS, patients with a higher postoperative mGPS had an increased risk of death (HR 3.05 (1.39-6.68), p=0.005) and recurrence (HR 2.98 (1.34-6.64), p?=?0.008). CONCLUSIONS Patients with an increase in mGPS following nephrectomy for ccRCC were more likely to die and experience cancer recurrence. Assessing dynamic changes in this cheap, validated, and reproducible test may be useful in identifying patients at higher risk for more aggressive disease or for counseling patients regarding risk of cancer recurrence. OBJECTIVE To describe how an intraoperative thermal injury to the ureter was handled during a robotic dismembered pyeloplasty. MATERIALS The patient was a 5 year old male who was undergoing robotic dismembered pyeloplasty for a symptomatic left ureteropelvic junction (UPJ) obstruction. The case started with cystoscopy and retrograde ureteral catheter placement prior to moving to the robotic part of the procedure. RESULTS During initial proximal ureteral dissection, there was an inadvertent thermal injury to the ureter due to arcing of the activated monopolar scissors via the fenestrated bipolar, which was providing upwards ureteral retraction. This was approximately 3 cm from the UPJ. The ureter was immediately pale. The dissection continued, freeing the remainder of the ureter and renal pelvis, however the injured ureter remained pale and the ureter proximal to this became mottled. There were concerns about ureteral viability. Given the voluminous renal pelvis available, the decision was made to perform a flap pyeloplasty, discarding the proximal ureter and bridging the resulting 3cm ureteral gap. The patient had a successful repair. The patient's post-operative course was uneventful and his stent was removed 6 weeks later. CONCLUSIONS While all surgeons hope that operations go as planned, unexpected situations will arise and adaptation to these adversities is required. It is important to recognize thermal injuries, evaluate them repeatedly during the case, and amend the reconstructive repair as necessary given the extent of damage and available tissues.